NKF Patient-Centered Outcomes Research Grant Application

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***STOP!***

Only use this form to start a NEW application.

If you've already started an application, use the link in the top right-hand corner to resume your application. Click "Next Page" to find and resume where you left off. 



Welcome!

Please review the Instructions to Applicants for National Kidney Foundation Patient-Centered Outcomes Research Grants before completing this application.

All applications and supplementary material are due by February 9, 2018.

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Applicant Information







Mailing Address






Project Information

Please do not exceed 255 characters, including spaces.

Academic and Professional Honors


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Sponsoring Institution










Division/Department or Facility Information


Department/Division or Facility Head Name












Documentation of Collaborative Arrangements

Upload letter(s) from consultant(s) indicating their willingness to assist in the scientific pursuit of this project and any conditions on such assistance, if applicable, and their CV(s). e.g. statistician who will be available to consult with regard to evaluation of data collected.

*All uploaded files must be in either PDF or Microsoft Word format








Facilities

Indicate the facilities available for the applicant's use and briefly describe their capacities, relative proximity and extent of availability for applicant's use. Use "other" to describe the facilities at any alternate or secondary research sites or field study sites pertinent to the applicant's research.




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Prior or Current Research Support


List all pending support (training, research, supplies, travel, etc.) that would run concurrently with the period covered by this application whether or not you are the Principal Investigator. Include the type, date, source and amount.
Pending Support 1





Pending Support 2





Pending Support 3





Pending Support 4





Pending Support 5






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Budget


Name of Fiscal Officer:





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Research Information





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PART I: Research Proposal  

Attach pages describing research proposal in the format described in the Instructions to Applicants.

Please observe the page limitations for each section of the research proposal as described.

*All uploaded files must be in either PDF or Microsoft Word format



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Letter of Commitment/Verification 


Attach letters of approval from the authorizing institution department head/facility director.


These must include:


- Verification of adequate time, space and resources, such as secretarial help to carry out the study.

- Waivers of administrative overhead and grant administration fees.

*All uploaded files must be in either PDF or Microsoft Word format

Click the "Browse" button to find the appropriate file on your computer. Clicking "Save and Close" will upload the file. The filenames CANNOT exceed 50 characters! You may upload over a previous document. Please do not change the filename.Click here to enter text



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References

Please list on this page names and contact information of three persons who are familiar with your scientific interests and abilities.

Then, download the following form, and ask them to use it to submit references.

Reference Form - DOC

Have each reference e-mail her/his completed form to: Julia.Schrogin@kidney.org

Reference 1

Full Name




Reference 2

Full Name




Reference 3

Full Name




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Signatures

  • The individuals signing below attest that:

    1. research funded pursuant to this application will be conducted as described herein and
    2. that institutional resources will be made available, as specified, to pursue this investigation. They agree to follow the terms and comply with the policies for the research funding mechanism for which funding is sought.
  • Note: By signing this application electronically, I certify the information provided is accurate, and the department head and fiscal officer have reviewed all information. I understand that an electronic signature has the same effect and can be enforced in the same way as a written signature.








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